Category Archives: therapist

I started a weight loss program last week, deciding that my condition was not going to change unless I actually did something significantly different. I find that I move along aware of the problem, thinking about the problem, wishing my habits would change, even planning to change, but not taking the steps needed. (It reminds me of the long touted saying , ” Insanity is doing the same thing over and over again and expecting different results.”) So I changed something. I find I do better with support, so I joined an organized program. Others like to take on these challenges with fierce independence. If there is something you want to change, choose a path that works for you, that addresses your challenges.

The process of making changes is interesting. I find that too often I start with goals that are too big. I often start with the end goal. Transformation takes place one step at a time. Think of building a house. I picture the finished house, then start looking at all the aspects of completing a house and feel overwhelmed. It’s not really an effective way to get things done. Breaking into pieces and identifying the sequence helps the task actually get accomplished. Get the plans, get the permit, complete the foundation, raise the walls, build the roof… you get the picture. Some people might call these baby steps and maybe they are. It’s a process of breaking down the task into segments that can be identified, defined, and accomplished. If you skip any steps, the end product doesn’t materialize.

All projects, (losing weight, building houses, changing habits, seeking help) start with incremental steps. They take time and perseverance. Change is a project. My project is a pretty big one. I’m sure there will be roadblocks, maybe set-backs, but I intend to keep going toward completing the project, one do-able task at a time.

You can do this, too.

Take Care,

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Remember, this forum is not intended to be therapy. I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching. These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I will be required to report my concerns of harm to self or others, and suspected abuse of children and vulnerable adults. I am located and providing these services in Washington State.

Again, I am open to communicating directly with you through this forum. If you have questions or concerns, please let me know. I will attempt to address them if I can.

Sunday was my mother’s birthday. At least it would have been, if she were still living. She died in 2008 when she was 88 years old. It is strange to be the oldest generation now in the family, something we babyboomers never really anticipated. Maybe no generation expects to get to a time when they are the elders. Not many of us have parents, aunts, or uncles any more, even if we’re from families known for longevity.

When I think of my mother, I am reminded that many theories within the world of mental health look to mothers as the source of our health or illness. I remember my mother-in-law resisting the idea that my husband (her son) would benefit from seeing a therapist. “They all just blame the mother,” she said. And I believe she worried that someone she never met would blame her for her son’s depression. My mother, on the other hand, took that fear and wrapped it around her like a Kevlar jacket, preventing any inkling of contribution to anyone’s unhappiness from penetrating the shell. Once when I asked why she said such mean things about people (she had referred to a family member as a fat cow), she replied, “Because I can, and I like it.” She subscribed to the “every man for himself” theory of child rearing – even if that “man” were a toddler. She was energetic, hard-working, and very capable of being the center of attention. There never was a power struggle she could walk away from. It wasn’t until I was much older and experienced that I realized she was trying to as hard as she could to establish her place in this world. She hated asking for help. In her experience, assistance always came with a package of shame, tied up in many strings. Asking for help meant she had failed. The person providing assistance would always know this, and could use it to maintain superiority over her. Sometimes that person was my father: sometimes it was her father.

I believe it is true that much of our emotional development is influenced by the people who raise us, or abandon us. It is also influenced by our genetic composition, as continued DNA and gene studies show. The general circumstances of the times when we are children affect us, as witnessed by those of us raised by survivors of the Great Depression. Even the trauma of our parents or grandparents can influence the way we view the world and our place in it, as seen in families where there were survivors of the Holocaust, or colonization of the Native American, or veterans of combat.

Families and other communities create a culture that defines normalcy for its children. Only as they explore other worlds, do developing minds and identities see alternatives. The exposure doesn’t require travel. Those other worlds might be found at school, with friend’s families, at the elderly neighbor’s home, in books, movies, and other media. I have always believed that my opportunity to spend extended time with my older cousin’s family allowed me to see a marriage relationship so different from my parents’, that I no longer saw theirs as the “normal,” and could have options in my relationship repertoire. I believe teachers have provided children exposure to adult-child relationships vastly different from parental ones. I have been saddened by the increasing restrictions on teacher-child interactions resulting from reactions to isolated abuse, and to funding driven emphasis on the rote aspects of learning over the social development activities. Today’s children seem to have a group of trainers – school, soccer, piano, gymnastics. I wish there were more adult friends, teachers, and mentors.

I wanted to be a therapist so I could be a mentor, a guide, a helper to persons looking for alternatives to how they were living their emotional life. Feeling better is much more than just changing the path you are on. It is really helpful to have an idea of where you want to go. In Alice in Wonderland, Alice asks the Cheshire Cat to help her find her way. The cat replies, “Well, that depends on where you want to get to.” Alice responds,” Oh it really doesn’t matter, as long…(as it isn’t here).” The cat’s answer? ” Then it really doesn’t matter which way you go.” Think about what you would like the new place to be. How would you feel? What behaviors would be different? How would your self-talk change? How would your relationships be different? With a therapist you can head toward that new place with support and guidance. Change happens.

Whether you call the process Therapy or Counseling, there are many misconceptions about it. I don’t pretend to know all the issues, but there are several I have run across – as a seeker and as a provider.

Your therapist cannot “fix” you. First, this assumes you need fixing, and secondly, it assumes the repair work is completed by someone else. Healing from loss or trauma is a process that you take on. Changing behaviors that create barriers to your happiness takes a process of awareness and practice. In therapy, you choose a guide to assist you with the processes. Remember, the answers are within you and your therapist helps you find them – your solutions, not theirs. As you engage in a relationship with your provider, your patterns of interacting with others rise to the surface. So do the relationship behaviors of the provider (more about that in another post).

Your therapist is not your friend. You are not paying for friendship. This seems to be an accusation that comes from others who for reasons of their own, need to discourage your healing experience. Your relationship with your provider has specific boundaries regarding when and where you meet, and has a specific purpose – to guide you in identifying and achieving your emotional or relationship goals, or to relieve your symptoms of distress. Friendships are reciprocal in a way that counseling relationships are not. Both parties have roles, but they are not the same as friends. Don’t call your therapist for a ride after dropping your car off at the dealer’s, and don’t expect to be invited to their summer barbecue.

The actual rigidity of professional boundaries is affected by many things, including the size of community you live in. Living in Seattle, you might never even see your provider out of the office. If you do, they might not acknowledge you unless you have indicated a connection first. In a much smaller community, you may interact frequently, sharing the kids’ soccer field, the grocery store, church, or even social groups. Not acknowledging you in public in this setting might be viewed as “snubbing.” How you prefer to deal with these situations will probably be a session discussion topic. Whether in a small or large community, you have the right to have your professional relationship kept confidential if that is what you prefer. No matter the setting, sexual relationships and providers using the therapy relationship for personal gain are never appropriate.

When I say that your counselor is not your friend, I don’t mean they do not care about you. It is a relationship and a collaboration. My experience is that providers share consumers’ successes and concerns. Depending on treatment orientation, your therapist may have accepted the responsibility of modeling nurturing behaviors such as acceptance, encouragement, and responsiveness. They expect to care about you.

Paying for assistance does not reduce its value. You have chosen to engage in a relationship with a specific purpose. For the provider, this specific purpose is a professional service. You are paying for the education, training, and experience of your provider, as you would a doctor, mechanic, or plumber. Remember, in this process, you are the buyer and you have a right to choose the service you get. You are not obligated to “stick it out” if you are unhappy with the provider or the process. Ask for what you need. There is nothing wrong with looking for a provider and a methodology that works for you, or with changing providers and methodologies after you have started.

The credentials of your provider do not indicate relative competency or quality of care. There are several paths into the profession of psychotherapy. These include several master’s level degrees, nurse practitioners, PhD’s and MD’s. Other than the ability to prescribe medications, Psychiatrists (MD’s with specialized training) and Psychiatric Nurse Practitioners (Registered Nurses with specialized training and experience) do not necessarily have more counseling expertise. Many have less counseling /talk therapy training than the others. Clinical psychologists in Washington State have to have academic doctoral degrees and pass a licensing exam. Some states allow folks with Master’s degrees to be licensed as psychologists, and some states permit psychologists limited prescribing authority. Psychologists also do not necessarily have more counseling training or experience. They are often valued for their testing and assessment credentials. Master’s level degrees in social work, psychology, and counseling also offer entry into counseling. If you are looking for a therapist, explore their training and experience in the areas of concern you have. Above all, ask yourself after an interaction, ” Is this someone I could work with?”

Sometimes, the most difficult aspect of participating in therapy is the reactions of the people closest to you: The mother who believes she will be blamed for all your sorrows; The friend who wants your time and attention; The spouse who is afraid your therapist will tell you to leave your marriage; or the person who thinks you should just “buck up.”

The goal of therapy is positive change. Change is difficult for most people – even good change, so there may resistance on your part and from the people around you. Try to be accepting and patient with yourself and with them.

This is a journey of self discovery and healing.

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Remember, this forum is not intended to be therapy. I have no way to view your body language, hear your tone of voice, or see your emotional expressions. These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of harm to self or others, and suspected abuse of children and vulnerable adults. I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here. If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.